Subclinical vitamin D deficiency in neonates: definition and response to vitamin D supplements

Abstract

To determine the biological criteria for neonatal vitamin D deficiency, serum 25-hydroxyvitamin D (calcidiol), parathyroid hormone (PTH), calcium, phosphates, and alkaline phosphatase (ALP) activity were measured during the winter-spring period in 80 healthy neonates and their mothers 3-6 d after delivery. A longitudinal 3-mo survey of the serum biology of 52 of these neonates consuming formula was also performed to test the influence of their neonatal vitamin D status on the effects of two oral ergocalciferol supplements (500 and 1000 IU or 12.5 and 25 micrograms/d). At birth, 63.7% of the infants had calcidiol concentrations < or = 30 nmol/L. Most of them had no other biological sign evocative of vitamin D deficiency, but 14 neonates had low calcidiol concentrations and serum PTH concentrations > 60 ng/L, the upper limit of the adult normal range. They also had a significantly lower mean serum calcium concentration than did neonates with calcidiol concentrations > 30 nmol/L. On the basis of the association of low calcidiol concentrations (< or = 30 nmol/L) and high PTH concentrations (> 60 ng/L) as criteria for vitamin D deficiency, 24% of the neonates born to unsupplemented mothers were found to be vitamin D-deficient. Neonatal vitamin D status influenced the response of the infants to vitamin D supplements. Neonates with no sign of vitamin D deficiency showed similar changes in their serum calcidiol, calcium, phosphate, and PTH concentrations and ALP activity and no toxic effect (hypercalcemia or highly elevated calcidiol concentration) was observed whatever their vitamin D intake. In contrast, neonates with subclinical vitamin D deficiency had normalized serum PTH within 1 mo only when they were given 1000 IU ergocalciferol (25 micrograms)/d in addition to their formula.

Hypovitaminosis D in pregnancy and its correlation with preeclampsia and gestational diabetes mellitus

“…Moreover, there was a significant negative correlation between vitamin D level at term and in neonates and preeclampsia (r =-0.5024, p<0.0001 and r =-0.3610, p<0.005). This is in accordance with the study performed by Bodnar et al and Zeghoud et al 32,33 Gestational diabetes is a result of pregnancy induced insulin resistance and impaired compensating insulin secretion. Vitamin D improves insulin sensitivity by enhancing insulin responsiveness to glucose transport.…”

“…37 Zeghoud et al stated that maternal vitamin D status correlates strongly with that of the newborn. 33 The current study supports the hypothesis that Vitamin D deficiency is correlated with an increased risk of maternal complications as GDM and preeclampsia.…”

Maternal intake of vitamin D during pregnancy and risk of advanced beta cell autoimmunity and type 1 diabetes in offspring

“…The process leading to the destruction of the beta cells might be initiated even before birth [10], therefore the effect of early environmental determinants in utero may be of crucial importance. Because maternal vitamin D intake and status during pregnancy affect neonatal vitamin D status [11][12][13], the former is an important area to study when searching for factors potentially involved in the development of type 1 diabetes.…”

Dietary intake and use of dietary supplements in relation to demographic variables among pregnant Finnish women

“…Nutrient status, for example, the status of vitamin D, n-3 and n-6 fatty acids, of the fetus and newborn child is shown to be dependent on maternal intake during pregnancy (Connor et al 1996;Zeghoud et al 1997). The increased nutrient requirements during pregnancy can be met through a healthy and balanced diet with modest adjustments.…”